Lexington Park MD Opco LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

LEXINGTON PARK MD OPCO LLC

Practice address

21412 Great Mills Rd
Lexington Park, MD 20653-1203

Phone

(301) 863-7244

NPI assigned

Apr 21, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Batya Gorelick

Title

Coo

Phone

(301) 863-7244

Specialties & licenses 1

Addresses

Other names 1

• Chesapeake Shores Nursing Center Doing business as

Tax ID family

Chesapeake Shores Nursing Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lexington Park MD Opco LLC

  • Skilled Nursing Facility
  • Lexington Park, MD
  • NPI 1720709157
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682035200000",
    "number": "1255028007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 SYLVAN AVE",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076323315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21412 GREAT MILLS RD",
            "city": "LEXINGTON PARK",
            "state": "MD",
            "postal_code": "206531203",
            "telephone_number": "301-863-7244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEXINGTON PARK MD OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-21",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-19",
        "status": "A",
        "authorized_official_last_name": "GORELICK",
        "authorized_official_first_name": "BATYA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "301-863-7244"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chesapeake Shores Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Kohut, ADT
• Jacob Nathan Kott, DDS
• Bambii Kreal, CAC-AD
• Kristi Larson
• Shannon Rae Leghart, MAT, LAT, ATC ,BSAS
• Lexington Park MD Opco LLC
• Lexington Park Optometry, LLC
• Linda S Ball Counseling LCPC
• Julie Logan, LCSW-C
• LP Lexington Park LLC

• Rehabilitation Clinic/Center in Lexington Park, MD
• Providers in Lexington Park, MD by specialty
• Rehabilitation Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.